A wide variety of active and complicated behaviors can occur
during sleep and are more common than previously thought. These
disorders are known as "parasomnias." Problems such as sleepwalking
and acting out dreams are quite different from each other and
both warrant thorough evaluation. These disorders can result
in serious injuries to the patient and to bed partners or family
members. Sometimes people with these disorders avoid telling
their doctors about them out of a sense of embarrassment. It
is important to realize that these disorders have no direct relationship
to psychological or psychiatric disorders and they usually can
be very successfully treated. Paying close attention to the
obvious safety issues is essential.
Acting Out Dreams
People with rapid eye movement (REM) sleep behavior disorder
develop frightening nightmares, often with violent content, and
may act out these dreams, punching, kicking, or flailing about.
This disorder is fairly common, perhaps especially in elderly
adults. The potential for serious injuries to the patient and
bed partner may be significant and both thorough diagnosis and
good treatment are a must. Treatment is usually quite successful.
Sleepwalking and Sleep Terrors
These are disorders of non-REM sleep, the usually stable stage
of sleep in which dreaming is less likely. Sleepwalking may
be anything from getting up to the bathroom without really being
awake and not remembering it in the morning to very complicated
and dangerous behaviors such as going outside for a walk or even
driving a car. The person with sleep terrors often
sits bolt upright or runs from the bed appearing very frightened
and often screaming or yelling. This person is usually unaware
of what is happening and usually does not recall anything in
the morning. Violent or injurious episodes are possible with
each of these disorders. Good treatments are available.
Sleep-Related Eating
Some sleepwalking seems solely confined to getting up to eat.
People with sleep-related eating may have no awareness of what
they are doing, or may be at least partially aware and literally
unable to stop. They may eat leftovers or normal snacks and
they may also eat raw food or even non-food items. Good treatments
are available.
Nightmares
Nightmares usually do not involve abnormal behaviors during
sleep, but they are another form of treatable parasomnia. Nightmares
often lead to insomnia because the nightmare sufferer becomes
afraid to sleep. Good treatments are available, even when the
nightmares have been present for many years. |
